Sleep disorders during pregnancy

Sleep disorders are a frequent side-effect of pregnancy. Pregnant women face a multitude of physiological and hormonal changes that can disrupt their sleep. From insomnia to restless legs syndrome (RLS) and obstructive sleep apnea, these disorders can have a significant impact on the quality of life of expectant mothers. Understanding these sleep disorders is essential if we are to manage them better and promote restful sleep during pregnancy.

In this article, we'll explore in detail the different sleep disorders that pregnant women can face, as well as advice on how to faca them.

• What is a sleep disorder?
• Sleep disorders during pregnancy
• Insomnia
• Restless legs syndrome (RLS)
• Snoring and obstructive sleep apnea (OSA)
• Gastro-oesophageal reflux disease (GORD)
• How to preserve sleep quality during pregnancy?
• Wrapping up

What is a sleep disorder?

According to medical dictionaries, a sleep disorder is any disturbance in the duration and/or quality of sleep. The cause may be psychological, environmental or behavioral. The consequences for your social, professional and emotional life, as well as your health, can be serious, which is why it's important to treat these disorders.

According to the Sleep Foundation, there are a multitude of categories of sleep disorders, the most common of which are listed below:

• Insomnia: generally, this refers to difficulty falling asleep and/or staying asleep, either acutely or chronically.
• Sleep disorders related to breathing
• Obstructive sleep apnea syndrome: results from partial or complete obstruction of the airways, and despite the efforts made by the body to breathe, the air does not pass.
• Snoring
• Hypersomnias: these are characterized by constant severe daytime sleepiness, due to sleep of normal or excessive duration, but which is not restful or restorative.
• Narcolepsy: a rare chronic disease characterized by sleep of normal duration but poor quality, resulting in excessive daytime sleepiness and uncontrollable falling asleep at any time of the day, even when fully active.
• Disorders of the circadian rhythm of sleep
• Parasomnias: a group of disorders characterized by abnormal behavior and undesirable experiences at the time of falling asleep or during sleep, such as confusional awakenings, night terrors, nightmares and paralysis.
• Sleepwalking: a series of automatic, unconscious movements and actions during sleep, which are not remembered on waking.
• Behavioral disorder in REM sleep: the dreamer mimes his dreams and emits vocalisations.
• Sleep-related movements
• Bruxism: involuntary grinding or chattering of the teeth during sleep.
• Restless legs syndrome (RLS): an urgent need to move the legs, tingling sensations, pins and needles, or electric current sensations, mainly at rest.
• Sleep disorders associated with pathologies
• Gastro-oesophageal reflux disease (GORD): reflux of stomach contents into the oesophagus, caused by a defect in the muscle that closes off this part of the digestive tract.

All these disorders are affecting more and more people and are not to be taken lightly. No matter how serious they are, they need to be monitored and treated promptly to avoid any deterioration in quality of life and health.

Unfortunately, pregnant women are equally, if not more, affected by some of these disorders during their pregnancies (and even afterwards).

Sleep disorders during pregnancy

Sleep disorders are common in pregnant women due to the many physiological and hormonal changes they undergo. Sleep disorders frequently observed in pregnant women are :

Insomnia

Insomnia is a frequent issue for pregnant women, especially during the first and third trimesters.

During the first trimester of pregnancy, sleep disorders are often attributable to the stress and anxiety that frequently arise after confirmation of pregnancy. In addition, the hormonal changes specific to this period can disrupt the usual sleep/wake cycles. The settling of the foetus in the uterus also stimulates the bladder, forcing the mother-to-be to get up at night to urinate. These various factors lead to restless nights, impaired sleep quality and daytime sleepiness, which sometimes forces pregnant women to take naps on their return from work. All these factors disrupt the daily sleep rhythm of the mother-to-be.

During the third trimester, it's mainly physical symptoms that disturb pregnant women's sleep. Cramps, back pain, the frequent need to urinate, the uncomfortable position due to a large belly, the active movements of the baby in the uterus, and worries about giving birth can all make sleep difficult. Finding a comfortable sleeping position becomes a challenge, and breathing difficulties can also affect sleep quality.

Restless legs syndrome (RLS) 

Pregnant women have an increased risk of developing RLS due to a number of pregnancy-related factors, such as:

• Hormonal changes: during pregnancy, levels of hormones such as estrogen and progesterone fluctuate considerably. These hormonal changes can affect the central nervous system and influence the regulation of certain neurotransmitters, such as dopamine and iron, which may be associated with the development of RLS.
• Iron deficiency anemia: pregnancy increases the need for iron to support the growth of the foetus and the mother's blood mass. This leads to iron deficiency, known as iron deficiency anemia, which is considered a risk factor for RLS. Low levels of iron in the body can disrupt the function of the nervous system and contribute to the onset of RLS symptoms.
• Venous compression: as the uterus expands to accommodate the growing foetus, it exerts pressure on the surrounding blood vessels and nerves, leading to impaired blood circulation and nerve function, which encourages the development of RLS.
• Genetic factors: studies have shown that RLS can be linked to genetic predisposition. If a woman has a family history of this syndrome, she may be at greater risk of developing the disorder during pregnancy.

Snoring and obstructive sleep apnea (OSA)

Pregnancy induces a number of physiological changes, making pregnant women more prone to snoring and OSA, such as :

• Swelling of the airways: increased estrogen levels cause swelling of the soft tissues of the upper airways. This swelling causes the airways to narrow, increasing the risk of snoring and OSA.
• Weight gain: during pregnancy, weight gain is common and necessary for the development of the foetus. However, this increase in weight will exert additional pressure on the airways, causing them to narrow and thus increasing the risk of snoring and OSA.
• Compression of the uterus: as the uterus expands to accommodate the growing foetus, it puts pressure on the diaphragm and lungs, reducing lung capacity and airflow. This can increase the risk of airway obstruction during sleep, leading to OSA.
• Nasal congestion: many pregnant women experience nasal congestion due to increased hormone levels and dilated blood vessels in the nose. Nasal congestion leads to breathing through the mouth rather than the nose and increases the risk of snoring and OSA.

Gastro-oesophageal reflux disease (GORD)

This condition is also a disorder affecting the nights of pregnant women, due to the following causes:

• Relaxation of the lower oesophageal sphincter (LOS): the LOS is a muscle located between the oesophagus and the stomach. It plays a crucial role in preventing acid reflux by preventing stomach contents from flowing back up into the esophagus. During pregnancy, hormones, in particular estrogen and progesterone, cause the LOS to relax, allowing acidic stomach contents to flow back into the oesophagus, leading to GORD.
• Pressure exerted by the uterus: as the uterus expands to accommodate the growing foetus, it exerts pressure on the stomach, compressing it and encouraging the reflux of acidic contents into the oesophagus.
• Slow digestion: during pregnancy, the rate of digestion can be slowed down due to the increased production of certain hormones and the relaxation of the smooth muscles of the digestive system. This slowness prolongs the time it takes for the stomach to 'empty' and increases the risk of GORD.

Every pregnant woman's experience of sleep disorders is different. Some may experience all of these problems, while others may experience only some, or none at all. It is therefore essential to take individual needs into account and look for suitable strategies to improve sleep quality during pregnancy, and to consult a healthcare professional when the need arises.

How to preserve sleep quality during pregnancy?

Everyone works in a different way, but there are some basic 'rules' for getting a good night's sleep, even during pregnancy.

• Adopt a regular sleep routine: try to go to bed and wake up at set times to establish a regular sleep routine. This can help your body regulate itself and promote better sleep.
• Create a sleep-friendly environment: make sure your bedroom is dark, quiet and comfortable. Use blackout curtains, earplugs or eye masks if necessary. Choose a supportive mattress and pillows that encourage good sleeping position.
• Avoid stimulants: reduce your caffeine intake and avoid consuming it in the afternoon or evening. Also avoid heavy, spicy meals before bedtime, as they can cause digestive problems and disrupt your sleep.
• Exercise regularly: regular exercise can help reduce stress, improve circulation and promote better quality sleep. Choose activities that are gentle and safe for pregnant women, such as walking, swimming or prenatal yoga.
• Practice relaxation: before bedtime, engage in relaxing activities to calm your mind and help you unwind, such as meditation, deep breathing, gentle yoga or reading a soothing book.
• Find a comfortable sleeping position: experiment with different sleeping positions to find the one that's most comfortable for you during pregnancy. Sleeping on your left side is often recommended, as it promotes better blood flow to the foetus and organs. The MedCline Reflux Relief System keeps your body in this doctor-recommended position (on the left side and inclined) while giving you support and comfort throughout the night.
• Manage physical discomfort: use support pillows to relieve lower back pain, place a pillow between your legs to support your hips and relieve pressure, or use a nursing pillow to find a comfortable position. The MedCline Therapeutic Body Pillow allows you to sleep on your side thanks to its 'J' shape, which aligns your spine and reduces joint and muscle pain, while still being able to place it between your knees. Its shredded memory foam filling provides customized support and optimum comfort for pregnant women.
• Limit liquids before bedtime: reduce your fluid intake a few hours before bedtime to minimise frequent urination during the night.
• Seek medical support: if you are experiencing persistent sleep problems, discuss them with a healthcare professional. He or she will be able to give you further advice, assess your symptoms and recommend solutions tailored to your situation.

Wrapping up

Pregnancy is an extraordinary time, but it can also bring many challenges, particularly when it comes to sleep. Sleep disorders can have an impact on the health and well-being of pregnant women, as well as on their ability to prepare for the arrival of their baby. However, by understanding common sleep disorders and adopting appropriate self-care strategies, pregnant women can improve their sleep quality and overall well-being. It is always advisable to consult a healthcare professional for advice specific to your situation. By taking care of their sleep, expectant mothers can feel more rested, energetic and ready to take full advantage of this unique time in their lives.